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Enweasor C, Flayer CH, Haczku A. Ozone-Induced Oxidative Stress, Neutrophilic Airway Inflammation, and Glucocorticoid Resistance in Asthma. Front Immunol 2021; 12:631092. [PMID: 33717165 PMCID: PMC7952990 DOI: 10.3389/fimmu.2021.631092] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/18/2021] [Indexed: 12/15/2022] Open
Abstract
Despite recent advances in using biologicals that target Th2 pathways, glucocorticoids form the mainstay of asthma treatment. Asthma morbidity and mortality remain high due to the wide variability of treatment responsiveness and complex clinical phenotypes driven by distinct underlying mechanisms. Emerging evidence suggests that inhalation of the toxic air pollutant, ozone, worsens asthma by impairing glucocorticoid responsiveness. This review discusses the role of oxidative stress in glucocorticoid resistance in asthma. The underlying mechanisms point to a central role of oxidative stress pathways. The primary data source for this review consisted of peer-reviewed publications on the impact of ozone on airway inflammation and glucocorticoid responsiveness indexed in PubMed. Our main search strategy focused on cross-referencing "asthma and glucocorticoid resistance" against "ozone, oxidative stress, alarmins, innate lymphoid, NK and γδ T cells, dendritic cells and alveolar type II epithelial cells, glucocorticoid receptor and transcription factors". Recent work was placed in the context from articles in the last 10 years and older seminal research papers and comprehensive reviews. We excluded papers that did not focus on respiratory injury in the setting of oxidative stress. The pathways discussed here have however wide clinical implications to pathologies associated with inflammation and oxidative stress and in which glucocorticoid treatment is essential.
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Affiliation(s)
- Chioma Enweasor
- UC Davis Lung Center, University of California, Davis, CA, United States
| | - Cameron H. Flayer
- Center for Immunology and Inflammatory Diseases, Division of Rheumatology, Allergy and Immunology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Angela Haczku
- UC Davis Lung Center, University of California, Davis, CA, United States
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New Approach Methods to Evaluate Health Risks of Air Pollutants: Critical Design Considerations for In Vitro Exposure Testing. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17062124. [PMID: 32210027 PMCID: PMC7143849 DOI: 10.3390/ijerph17062124] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 03/11/2020] [Accepted: 03/19/2020] [Indexed: 12/20/2022]
Abstract
Air pollution consists of highly variable and complex mixtures recognized as major contributors to morbidity and mortality worldwide. The vast number of chemicals, coupled with limitations surrounding epidemiological and animal studies, has necessitated the development of new approach methods (NAMs) to evaluate air pollution toxicity. These alternative approaches include in vitro (cell-based) models, wherein toxicity of test atmospheres can be evaluated with increased efficiency compared to in vivo studies. In vitro exposure systems have recently been developed with the goal of evaluating air pollutant-induced toxicity; though the specific design parameters implemented in these NAMs-based studies remain in flux. This review aims to outline important design parameters to consider when using in vitro methods to evaluate air pollutant toxicity, with the goal of providing increased accuracy, reproducibility, and effectiveness when incorporating in vitro data into human health evaluations. This review is unique in that experimental considerations and lessons learned are provided, as gathered from first-hand experience developing and testing in vitro models coupled to exposure systems. Reviewed design aspects include cell models, cell exposure conditions, exposure chambers, and toxicity endpoints. Strategies are also discussed to incorporate in vitro findings into the context of in vivo toxicity and overall risk assessment.
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Flayer CH, Ge MQ, Hwang JW, Kokalari B, Redai IG, Jiang Z, Haczku A. Ozone Inhalation Attenuated the Effects of Budesonide on Aspergillus fumigatus-Induced Airway Inflammation and Hyperreactivity in Mice. Front Immunol 2019; 10:2173. [PMID: 31572383 PMCID: PMC6753328 DOI: 10.3389/fimmu.2019.02173] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 08/28/2019] [Indexed: 12/31/2022] Open
Abstract
Inhaled glucocorticoids form the mainstay of asthma treatment because of their anti-inflammatory effects in the lung. Exposure to the air pollutant ozone (O3) exacerbates chronic airways disease. We and others showed that presence of the epithelial-derived surfactant protein-D (SP-D) is important in immunoprotection against inflammatory changes including those induced by O3 inhalation in the airways. SP-D synthesis requires glucocorticoids. We hypothesized here that O3 exposure impairs glucocorticoid responsiveness (including SP-D production) in allergic airway inflammation. The effects of O3 inhalation and glucocorticoid treatment were studied in a mouse model of allergic asthma induced by sensitization and challenge with Aspergillus fumigatus (Af) in vivo. The role of O3 and glucocorticoids in regulation of SP-D expression was investigated in A549 and primary human type II alveolar epithelial cells in vitro. Budesonide inhibited airway hyperreactivity, eosinophil counts in the lung and bronchoalveolar lavage (BAL) and CCL11, IL-13, and IL-23p19 release in the BAL of mice sensitized and challenged with Af (p < 0.05). The inhibitory effects of budesonide were attenuated on inflammatory changes and were completely abolished on airway hyperreactivity after O3 exposure of mice sensitized and challenged with Af. O3 stimulated release of pro-neutrophilic mediators including CCL20 and IL-6 into the airways and impaired the inhibitory effects of budesonide on CCL11, IL-13 and IL-23. O3 also prevented budesonide-induced release of the immunoprotective lung collectin SP-D into the airways of allergen-challenged mice. O3 had a bi-phasic direct effect with early (<12 h) inhibition and late (>48 h) activation of SP-D mRNA (sftpd) in vitro. Dexamethasone and budesonide induced sftpd transcription and translation in human type II alveolar epithelial cells in a glucocorticoid receptor and STAT3 (an IL-6 responsive transcription factor) dependent manner. Our study indicates that O3 exposure counteracts the effects of budesonide on airway inflammation, airway hyperreactivity, and SP-D production. We speculate that impairment of SP-D expression may contribute to the acute O3-induced airway inflammation. Asthmatics exposed to high ambient O3 levels may become less responsive to glucocorticoid treatment during acute exacerbations.
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Affiliation(s)
- Cameron H Flayer
- Department of Internal Medicine, University of California, Davis, Davis, CA, United States
| | - Moyar Q Ge
- Department of Internal Medicine, University of California, Davis, Davis, CA, United States.,Department of Internal Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Jin W Hwang
- Department of Internal Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Blerina Kokalari
- Department of Internal Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Imre G Redai
- Department of Internal Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Zhilong Jiang
- Department of Internal Medicine, University of California, Davis, Davis, CA, United States.,Department of Internal Medicine, University of Pennsylvania, Philadelphia, PA, United States.,Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Angela Haczku
- Department of Internal Medicine, University of California, Davis, Davis, CA, United States.,Department of Internal Medicine, University of Pennsylvania, Philadelphia, PA, United States
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Starkhammar M, Kumlien Georén S, Dahlén SE, Cardell LO, Adner M. TNFα-blockade stabilizes local airway hyperresponsiveness during TLR-induced exacerbations in murine model of asthma. Respir Res 2015; 16:129. [PMID: 26494305 PMCID: PMC4618779 DOI: 10.1186/s12931-015-0292-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 10/09/2015] [Indexed: 01/11/2023] Open
Abstract
Viral infections are a common cause of asthma exacerbation. These maladies are sometimes complicated by bacterial infections. Toll-like receptors (TLRs) are in the forefront of our microbial defence, with TLR3 responding to viral and TLR4 to bacterial stimulation. The present study was designed to evaluate the effect of concomitant TLR3 and TLR4 stimulation in a murine model of allergic asthma. BALB/c mice were stimulated intranasally with a combination of poly(I:C) and LPS activating TLR3 and TLR4, respectively. This resulted in the development of airway hyperresponsiveness (AHR) in the proximal part of the lung, along with signs of neutrophilic inflammation. Analysis of the bronchioalveolar lavage fluid (BALF) revealed a marked increase in TNFα. In contrast, the allergic airway inflammation induced by ovalbumin administration to sensitized mice caused AHR in the whole lung along with an increase in eosinophils and lymphocytes in the BALF and lung. When poly(I:C) + LPS were given to mice with an ongoing allergic airway inflammation induced by ovalbumin, the AHR was further increased in the peripheral lung and neutrophils appeared together with eosinophils and lymphocytes in the BALF and lung. Treatment with the TNFα-blocking antibody infliximab blunted the AHR increase, without affecting the cells influx in BALF. To conclude; a combined TLR3- and TLR4-stimulation, representing a concomitant viral and bacterial infection, causes an AHR that is further exaggerated during an ongoing allergic inflammation. The airway stabilizing effect of infliximab indicates the possible future use of TNFα blockade in treatment of microbial induced exacerbations of allergic asthma.
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Affiliation(s)
- Magnus Starkhammar
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.,Division of ENT diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden.,Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Susanna Kumlien Georén
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.,Division of ENT diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Sven-Erik Dahlén
- Division of ENT diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lars-Olaf Cardell
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.,Division of ENT diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden.,Department of ENT Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - Mikael Adner
- Division of ENT diseases, CLINTEC, Karolinska Institutet, Stockholm, Sweden. .,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. .,Unit of Experimental Asthma and Allergy Research, Institute of Environmental Medicine, Scheeles väg 1, Karolinska Institutet, SE-171 77, Stockholm, Sweden.
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Damera G, Panettieri RA. Irreversible airway obstruction in asthma: what we lose, we lose early. Allergy Asthma Proc 2014; 35:111-8. [PMID: 24717787 DOI: 10.2500/aap.2013.34.3724] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Asthma, a syndrome manifested by airway inflammation and obstruction, globally contributes significantly to morbidity and mortality. Although current evidence identifies risk factors that evoke asthma, critical questions concerning susceptibility factors that induce severe persistent disease remain unclear. Early onset of asthma decreases lung function that may be unrecognized until later in adulthood when patients experience dyspnea on exertion and attenuated quality of life. This review highlights current evidence in predicting the onset of asthma and identifying those patients at greatest risk for severe persistent disease.
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Affiliation(s)
- Gautam Damera
- Translational Medicine, Respiratory, Inflammation, and Autoimmunity Group, MedImmune, LLC, Gaithersburg, Maryland, USA
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Yokohira M, Nakano Y, Yamakawa K, Kishi S, Ninomiya F, Saoo K, Imaida K. Strain differences in pleural mesothelial cell reactions induced by potassium octatitanate fibers (TISMO) infused directly into the thoracic cavity. ACTA ACUST UNITED AC 2013; 65:925-32. [PMID: 23375775 DOI: 10.1016/j.etp.2013.01.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2012] [Revised: 11/21/2012] [Accepted: 01/04/2013] [Indexed: 11/24/2022]
Abstract
Although we have previously reported that the fiber-shaped TISMO, morphologically similar to asbestos, can induce a severe mesothelial reaction in A/J mice, it is important to clarify any strain differences. In the present study, female A/J, C3H/HeN, ICR and C57BL/6 mice were therefore employed as test strains. At the beginning of the experiment, all mice underwent a left thoracotomy and direct administration of 3mg of TISMO particles suspended in 0.2 ml saline into the left thorax. The experiment was terminated after 21 weeks and all groups were sacrificed and the mesothelium and main organs were examined histopathologically. To contribute to mechanistic analysis, iron staining with Berlin blue and Turnbull's blue, and immunostaining for calretinin were also performed. The present experiment demonstrated only minor strain differences in the degree of pleural reaction to TISMO. However, there was clear variation in the iron and lymphocyte accumulation in the pleura and in the liver. This difference in response to TISMO fibers in vivo is important information when considering the development of mesothelioma as an animal model and the extrapolation to human risk from such animal studies.
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Affiliation(s)
- Masanao Yokohira
- Onco-Pathology, Department of Pathology and Host-Defense, Kagawa University, Kagawa 761-0793, Japan
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Lummus ZL, Wisnewski AV, Bernstein DI. Pathogenesis and disease mechanisms of occupational asthma. Immunol Allergy Clin North Am 2012; 31:699-716, vi. [PMID: 21978852 DOI: 10.1016/j.iac.2011.07.008] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Occupational asthma (OA) is one of the most common forms of work-related lung disease in all industrialized nations. The clinical management of patients with OA depends on an understanding of the multifactorial pathogenetic mechanisms that can contribute to this disease. This article discusses the various immunologic and nonimmunologic mechanisms and genetic susceptibility factors that drive the inflammatory processes of OA.
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Affiliation(s)
- Zana L Lummus
- Department of Internal Medicine, University of Cincinnati College of Medicine, 3255 Eden Avenue, Cincinnati, OH 45267-0563, USA
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Auten RL, Foster WM. Biochemical effects of ozone on asthma during postnatal development. Biochim Biophys Acta Gen Subj 2011; 1810:1114-9. [PMID: 21276837 DOI: 10.1016/j.bbagen.2011.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Revised: 01/05/2011] [Accepted: 01/21/2011] [Indexed: 01/07/2023]
Abstract
BACKGROUND Ozone exposure during early life has the potential to contribute to the development of asthma as well as to exacerbate underlying allergic asthma. SCOPE OF REVIEW Developmentally regulated aspects of sensitivity to ozone exposure and downstream biochemical and cellular responses. MAJOR CONCLUSIONS Developmental differences in antioxidant defense responses, respiratory physiology, and vulnerabilities to cellular injury during particular developmental stages all contribute to disparities in the health effects of ozone exposure between children and adults. GENERAL SIGNIFICANCE Ozone exposure has the capacity to affect multiple aspects of the "effector arc" of airway hyperresponsiveness, ranging from initial epithelial damage and neural excitation to neural reprogramming during infancy. This article is part of a Special Issue entitled: Biochemistry of Asthma.
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Affiliation(s)
- Richard L Auten
- Department of Pediatrics (Neonatal Medicine), Duke University, DUMC Box 3373, Durham, NC 27710, USA.
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Säfholm J, Lövdahl C, Swedin L, Boels PJM, Dahlén SE, Arner A, Adner M. Inflammation-induced airway smooth muscle responsiveness is strain dependent in mice. Pulm Pharmacol Ther 2011; 24:361-6. [PMID: 21255673 DOI: 10.1016/j.pupt.2011.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Revised: 12/27/2010] [Accepted: 01/08/2011] [Indexed: 11/26/2022]
Abstract
Different mouse strains display different degrees of inflammation-induced airway hyperresponsiveness in vivo. It is not known whether these variations are attributable to distinct properties of the airway smooth muscle. Therefore, tracheal ring segments from C57BL/6 and BALB/c mice were exposed to three different pro-inflammatory stimuli for 4 days while maintained under tissue-culture conditions: tumour necrosis factor α (100 ng/ml), the Toll-like receptor (TLR) 3 agonist polyI:C (10 μg/ml), and the TLR4 agonist LPS (10 μg/ml). The contractile responses to carbachol, 5-hydroxytryptamine (5-HT) and bradykinin were assessed after culture. In addition, gene expression of TLR1-TLR9, pivotal inflammatory signal transduction proteins (jun-kinase, p38 and p65) and critical negative regulators of inflammation (A20, Itch, Tax1bp1 and RNF11) were studied in tracheal smooth muscle strips, fresh and following treatment for 4 days with LPS, from both strains. No differences between the strains were detected regarding the response of freshly isolated preparations to carbachol, 5-HT and bradykinin. After stimulation with pro-inflammatory mediators, contractions in response to 5-HT and bradykinin, but not to carbachol, were up-regulated. This up-regulation was markedly larger in BALB/c than in C57BL/6 segments and depended on the type of inflammatory stimulus. Expression of the genes investigated did not differ between the two strains. These findings indicate that strain differences in airway hyperresponsiveness can be linked to differences in the responsiveness of airway smooth muscle to pro-inflammatory mediators per se. The differences do not appear to be due to differential expression of TLR or common inflammatory transduction and repressor proteins.
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Affiliation(s)
- Jesper Säfholm
- Institute of Environmental Medicine and the Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
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Variation of lipopolysaccharide-induced acute lung injury in eight strains of mice. Respir Physiol Neurobiol 2010; 171:157-64. [PMID: 20188866 DOI: 10.1016/j.resp.2010.02.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2009] [Revised: 02/16/2010] [Accepted: 02/18/2010] [Indexed: 11/19/2022]
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Alm AS, Li K, Yang D, Andersson R, Lu Y, Wang X. Varying susceptibility of pulmonary cytokine production to lipopolysaccharide in mice. Cytokine 2010; 49:256-63. [PMID: 20042347 DOI: 10.1016/j.cyto.2009.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2009] [Revised: 09/12/2009] [Accepted: 11/05/2009] [Indexed: 01/15/2023]
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Aubier M. L’homme est-il malade de son environnement ? Med Sci (Paris) 2006; 22:563-4. [PMID: 16828024 DOI: 10.1051/medsci/20062267563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Abstract
PURPOSE OF REVIEW Recent advances in molecular genetics clearly demonstrate that a patient's susceptibility to developing a common disease is the result of an underlying genetic predisposition. Gastroesophageal reflux disease (GERD) is proving to be no exception. The results of family and twin studies have identified an inherited tendency toward developing the disease, and a locus common to multiple families with severe GERD has been found on 13q14, known as GERD1. RECENT FINDINGS While it is clear that there are several genes that control susceptibility to GERD, recent advances are refining the location of GERD1. Genes associated with syndromic GERD may offer clues as to the nature of nonsyndromic GERD genes, and all cases of the disease may not be due to mutations in genes that follow simple Mendelian laws. SUMMARY While the pathology of GERD remains elusive, molecular genetic approaches offer the clearest path to elucidating the underlying mechanisms of the disease. Discovering the genes that control susceptibility to GERD will provide improved diagnostics and suggest new pharmacological agents for improved treatment. Future efforts should focus on identification of these genes, and clinicians with access to large GERD patient populations should collaborate with geneticists to accomplish this task. Mapping studies should be undertaken in populations of patients with infantile-onset and adult-onset GERD. Future epidemiologic and twin studies will be of limited value, unless the studies are designed to deliver more than simply confirmatory evidence that there is a hereditable component to GERD.
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Affiliation(s)
- J Christopher Post
- Center for Genomic Sciences, Allegheny Singer Research Institute, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
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